Websites
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British Heart Foundation
Funding body
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Oxford Heart Vessels and Fat (ox-HVF) cohort
Prospective translational programme
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Cardiovascular Research
Journal
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Reuters video on FAI technology
Press
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British Atherosclerosis Society
National Society
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The Lancet 2024
Video
Charalambos Antoniades
British Heart Foundation Chair of Cardiovascular Medicine
- Director, Acute Multidisciplinary Imaging and Interventional Centre (AMIIC)
- Deputy Head, Division of Cardiovascular Medicine
- Professor of Cardiovascular Medicine
- Honorary Consultant Cardiologist
- Chair of the British Atherosclerosis Society
Crosstalk between adipose tissue and the cardiovascular system: From target discovery to advanced imaging and risk prediction
Adipose tissue is now considered to be a “biochemical factory” in the human body, producing a wide range of bioactive molecules, such as adipokines. These molecules exert local autocrine effects, but they also have paracrine and endocrine properties, and may play a critical role in the regulation of redox state and signalling in various tissues, such as the vascular wall and myocardium. Our group studies the mechanisms by which different adipose tissue depots in the human body affect vascular and myocardial redox state in atherosclerosis. We also search for novel therapeutic strategies targeting vascular and myocardial redox signalling directly or through changes in the crosstalk between adipose tissue and cardiovascular system.
Our group undertakes translational research, moving from bench to bedside and vice versa. We use various clinical research tools, such as non-invasive imaging and others, for the evaluation of vascular / myocardial function. This includes studies on human tissues; we have developed a number of ex vivo models of human tissue (vessels, myocardium and adipose tissue) for translational research, which are complemented by tissue and cell culture techniques. We have also established a large bioresource of human vascular, myocardial and adipose tissue in collaboration with other academic institutions across the world (The Oxford Heart Vessels & Fat (ox-HVF) cohort) and this is currently being used to support hypothesis driven research in the field of vascular and myocardial redox state regulation.
In our lab state-of-the-art techniques are used to visualise and quantify vascular and myocardial free radical production.
Using genetic tools to identify patients with pre-specified genetic traits, enables us to apply a “recruit-by-genotype” approach to address biological questions related to the cross-talk between adipose tissue and vascular/myocardial redox signalling in human cardiovascular disease.
We are also using state-of-the-art non-invasive imaging techniques (advanced ultrasound and CT imaging techniques) to study the structure and function of the cardiovascular system and explore its interactions with the adipose tissue. This programme of work led to the recent discovery of the "inside-to-outside" signals from the human cardiovascular system to the adipose tissue, and allowed the development of new clinical applications of cardiovascular imaging.
Since 2015, the group runs the Oxford Cardiovascular Computed Tomography programme, in partnership with the Manor Hospital, supporting the use of state-of-the-art cardiovascular CT imaging by groups within the University of Oxford. The group is using artificial intellience and machine learning approaches to analyse radiotranscriptomic signatures that lead to the develpment of new imaging biomarkers. A recent example is that of the develpment of Fat Attenuation Index (FAI), a new biomarker that detects inflammation in the human coronary arteries by analysing the changes of weighed CT attenuation of perivascular adipose tissue (Science Transl Med 2017). FAI has striking predictive value for cardiac mortality and acute coronary events, as demonstrated in a large prospective clinical study (CRISP-CT) organised together with Erlangen University (Germany) and Cleveland Clinic (USA) (Lancet 2018).
Since 2015, the group runs the Oxford Academic cardiovascular Computed Tomography (OXACCT) programme, in partnership with the Manor Hospital, supporting the use of state-of-the-art cardiovascular CT imaging by groups within the University of Oxford. Within the group, we run the OXACCT Core Lab, peforming advanced analysis of cardiovascular CT images with specific focus on analysis of coronary plaques and perivascular adipose tissue.
Our group also organises small-scale randomised clinical trials that include extensive cardiovascular phenotyping, testing the effects of treatments (statins, folates etc) on the biology of the human vascular wall, myocardium and adipose tissue.
Key publications
Inflammatory risk and cardiovascular events in patients without obstructive coronary artery disease: the ORFAN multicentre, longitudinal cohort study.
Journal article
Chan K. et al, (2024), Lancet, 403, 2606 - 2618
Perivascular adipose tissue as a source of therapeutic targets and clinical biomarkers.
Journal article
Antoniades C. et al, (2023), Eur Heart J, 44, 3827 - 3844
Role of Human Epicardial Adipose Tissue-Derived miR-92a-3p in Myocardial Redox State.
Journal article
Carena MC. et al, (2023), J Am Coll Cardiol, 82, 317 - 332
Using artificial intelligence to study atherosclerosis, predict risk and guide treatments in clinical practice.
Journal article
Antoniades C. et al, (2023), Eur Heart J, 44, 437 - 439
Non-canonical WNT signalling in cardiovascular disease: mechanisms and therapeutic implications.
Journal article
Akoumianakis I. et al, (2022), Nat Rev Cardiol, 19, 783 - 797
Constructing custom-made radiotranscriptomic signatures of vascular inflammation from routine CT angiograms: a prospective outcomes validation study in COVID-19.
Journal article
Kotanidis CP. et al, (2022), Lancet Digit Health, 4, e705 - e716
Effects of canagliflozin on human myocardial redox signalling: clinical implications.
Journal article
Kondo H. et al, (2021), Eur Heart J, 42, 4947 - 4960
Standardized measurement of coronary inflammation using cardiovascular computed tomography: integration in clinical care as a prognostic medical device.
Journal article
Oikonomou EK. et al, (2021), Cardiovasc Res, 117, 2677 - 2690
Fat-Secreted Ceramides Regulate Vascular Redox State and Influence Outcomes in Patients With Cardiovascular Disease.
Journal article
Akawi N. et al, (2021), J Am Coll Cardiol, 77, 2494 - 2513
ificial intelligence in medical imaging: A radiomic guide to precision phenotyping of cardiovascular disease.
Journal article
Oikonomou EK. et al, (2020), Cardiovasc Res, 116, 2040 - 2054
Perivascular Fat Attenuation Index Stratifies Cardiac Risk Associated With High-Risk Plaques in the CRISP-CT Study.
Journal article
Oikonomou EK. et al, (2020), J Am Coll Cardiol, 76, 755 - 757
Elevated circulating amyloid concentrations in obesity and diabetes promote vascular dysfunction.
Journal article
Meakin PJ. et al, (2020), J Clin Invest, 130, 4104 - 4117
Insulin-induced vascular redox dysregulation in human atherosclerosis is ameliorated by dipeptidyl peptidase 4 inhibition.
Journal article
Akoumianakis I. et al, (2020), Sci Transl Med, 12
Imaging residual inflammatory cardiovascular risk.
Journal article
Antoniades C. et al, (2020), Eur Heart J, 41, 748 - 758
novel machine learning-derived radiotranscriptomic signature of perivascular fat improves cardiac risk prediction using coronary CT angiography.
Journal article
Oikonomou EK. et al, (2019), Eur Heart J, 40, 3529 - 3543
dipose tissue-derived WNT5A regulates vascular redox signaling in obesity via USP17/RAC1-mediated activation of NADPH oxidases.
Journal article
Akoumianakis I. et al, (2019), Sci Transl Med, 11
ssociation of Biologic Therapy With Coronary Inflammation in Patients With Psoriasis as Assessed by Perivascular Fat Attenuation Index.
Journal article
Elnabawi YA. et al, (2019), JAMA Cardiol, 4, 885 - 891
Non-invasive detection of coronary inflammation using computed tomography and prediction of residual cardiovascular risk (the CRISP CT study): a post-hoc analysis of prospective outcome data.
Journal article
Oikonomou EK. et al, (2018), Lancet, 392, 929 - 939
Detecting human coronary inflammation by imaging perivascular fat.
Journal article
Antonopoulos AS. et al, (2017), Sci Transl Med, 9
Mutual Regulation of Epicardial Adipose Tissue and Myocardial Redox State by PPAR-γ/Adiponectin Signalling.
Journal article
Antonopoulos AS. et al, (2016), Circ Res, 118, 842 - 855
diponectin as a link between type 2 diabetes and vascular NADPH oxidase activity in the human arterial wall: the regulatory role of perivascular adipose tissue.
Journal article
Antonopoulos AS. et al, (2015), Diabetes, 64, 2207 - 2219
Interactions between vascular wall and perivascular adipose tissue reveal novel roles for adiponectin in the regulation of endothelial nitric oxide synthase function in human vessels.
Journal article
Margaritis M. et al, (2013), Circulation, 127, 2209 - 2221
Myocardial redox state predicts in-hospital clinical outcome after cardiac surgery effects of short-term pre-operative statin treatment.
Journal article
Antoniades C. et al, (2012), J Am Coll Cardiol, 59, 60 - 70
Induction of vascular GTP-cyclohydrolase i and endogenous tetrahydrobiopterin synthesis protect against inflammation-induced endothelial dysfunction in human atherosclerosis
Journal article
Antoniades C. et al, (2011), Circulation, 124, 1860 - 1870
Rapid, direct effects of statin treatment on arterial redox state and nitric oxide bioavailability in human atherosclerosis via tetrahydrobiopterin-mediated endothelial nitric oxide synthase coupling.
Journal article
Antoniades C. et al, (2011), Circulation, 124, 335 - 345
Preoperative atorvastatin treatment in CABG patients rapidly improves vein graft redox state by inhibition of Rac1 and NADPH-oxidase activity.
Journal article
Antoniades C. et al, (2010), Circulation, 122, S66 - S73
The CD40/CD40 ligand system: linking inflammation with atherothrombosis.
Journal article
Antoniades C. et al, (2009), J Am Coll Cardiol, 54, 669 - 677
ltered plasma versus vascular biopterins in human atherosclerosis reveal relationships between endothelial nitric oxide synthase coupling, endothelial function, and inflammation.
Journal article
Antoniades C. et al, (2007), Circulation, 116, 2851 - 2859
Global improvement of vascular function and redox state with low-dose folic acid: implications for folate therapy in patients with coronary artery disease.
Journal article
Shirodaria C. et al, (2007), Circulation, 115, 2262 - 2270
Genetic polymorphisms of platelet glycoprotein Ia and the risk for premature myocardial infarction: effects on the release of sCD40L during the acute phase of premature myocardial infarction.
Journal article
Antoniades C. et al, (2006), J Am Coll Cardiol, 47, 1959 - 1966
Recent publications
Reimagining Thomas Lewis's perspective: using artificial intelligence tools to predict cardiovascular risk from computed tomography.
Journal article
Kotronias RA. et al, (2026), Heart
Evaluating Acute Ischemic Myocardial Injury With Photon-Counting Computed Tomography.
Journal article
Kotronias RA. et al, (2026), JACC Cardiovasc Imaging, 19, 284 - 287
natomical, physiological and inflammatory characterization of nonculprit vessels in patients undergoing primary PCI for ST-elevation myocardial infarction in the presence of multivessel disease: Rationale and design of the PICNIC study.
Journal article
Mahmoudi M. et al, (2026), Am Heart J, 292
Sex and gender differences in coronary pathophysiology and ischaemic heart disease.
Journal article
Manfrini O. et al, (2026), Eur Heart J
Imaging and Quantification of Perivascular Adipose Tissue.
Journal article
Foran D. et al, (2026), Arterioscler Thromb Vasc Biol
Lipoprotein(a) and Vascular Redox State in Patients With Advanced Coronary Atherosclerosis.
Journal article
Polkinghorne MD. et al, (2026), Arterioscler Thromb Vasc Biol, 46, 232 - 247
CT coronary angiography in the lipid clinic: a pilot study and lipidologist survey.
Journal article
Graby J. et al, (2025), Int J Cardiovasc Imaging, 41, 2205 - 2217
Effectiveness of a novel intervention (Super Rehab) in overweight patients with atrial fibrillation (SuRe AF): protocol for a randomised controlled trial.
Journal article
Murphy D. et al, (2025), BMJ Open, 15
Expression of Concern for Elevated circulating amyloid concentrations in obesity and diabetes promote vascular dysfunction.
Journal article
Meakin PJ. et al, (2025), J Clin Invest, 135
From lipids and inflammation to artificial intelligence-driven therapeutics: the 93rd European atherosclerosis society (EAS) congress 2025 in focus.
Journal article
Gurgone D. et al, (2025), Cardiovasc Res, 121, 1302 - 1305
Pericoronary Adipose Tissue Imaging and the Need for Standardized Measurement of Coronary Inflammation: Translating PCAT Attenuation Gradients Into FAI Score for Clinical Use.
Journal article
Antoniades C. and Chan K., (2025), JACC Cardiovasc Imaging, 18, 895 - 898
Coronary inflammation and cardiovascular risk in breast cancer after radiotherapy.
Journal article
Kotanidis CP. et al, (2025), Eur Heart J, 46, 2924 - 2927
Scalable screening for structural heart disease: promises from artificial intelligence-electrocardiogram tools.
Journal article
Antoniades C. and Chan K., (2025), Eur Heart J Digit Health, 6, 521 - 523
Cost-effectiveness of a novel AI technology to quantify coronary inflammation and cardiovascular risk in patients undergoing routine coronary computed tomography angiography.
Journal article
Tsiachristas A. et al, (2025), Eur Heart J Qual Care Clin Outcomes, 11, 434 - 444
Benchmarking Photon-Counting Computed Tomography Angiography Against Invasive Assessment of Coronary Stenosis: Implications for Severely Calcified Coronaries.
Journal article
Kotronias RA. et al, (2025), JACC Cardiovasc Imaging, 18, 572 - 585
Using artificial intelligence to spot heart failure from ECGs: is it prime time?
Journal article
Antoniades C. and Chan K., (2025), Eur Heart J, 46, 1054 - 1056
ssessing the impact of COmorbidities and Sociodemographic factors on Multiorgan Injury following COVID-19: rationale and protocol design of COSMIC, a UK multicentre observational study of COVID-negative controls.
Journal article
Shergill S. et al, (2025), BMJ Open, 15
Obesity and cardiovascular disease: an ESC clinical consensus statement.
Journal article
Koskinas KC. et al, (2025), Eur J Prev Cardiol, 32, 184 - 220
Intra-operative and post-operative management of conduits for coronary artery bypass grafting: a clinical consensus statement of the European Society of Cardiology Working Group on Cardiovascular Surgery and the European Association for Cardio-Thoracic Surgery Coronary Task Force.
Journal article
Sandner S. et al, (2025), Eur Heart J, 46, 19 - 34
Using artificial intelligence to study atherosclerosis from computed tomography imaging: A state-of-the-art review of the current literature.
Journal article
Klüner LV. et al, (2024), Atherosclerosis, 398
